Danièle Pacaud1, Anke Schwandt2,3, Carine de Beaufort4,5, Kristina Casteels6,7, Jacques Beltrand8,9, Niels H Birkebaek10, Myrna Campagnoli11, Natasa Bratina12, Catarina Limbert13, Stephen Mp O'Riordan14, Rogério Ribeiro15, Andriani Gerasimidi-Vazeou16, Lenka Petruzelkova17, Rasa Verkauskiene18, Iveta Dzivite Krisane19. 1. Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada. daniele.pacaud@ahs.ca. 2. Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany. 3. German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany. 4. Diabetes and Endocrinology Care Clinique Pédiatrique (DECCP), Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg. 5. Division of Paediatric Endocrinology, University Hospital Brussels, Brussels, Belgium. 6. Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium. 7. Department of Development and Regeneration, KU Leuven, Leuven, Belgium. 8. Service d'endocrinologie gynécologie et diabétologie pédiatrique, Hôpital Universitaire Necker Enfants Malades, Assistance publique Hôpitaux de Paris, Paris, France. 9. Faculté de médecine Paris Descartes, Université Sorbonne Paris cité, Paris, France. 10. Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark. 11. Centro de Diabetes de Curitiba, Paraná, Brazil. 12. Departement of endocrinology, diabetes and metabolic diseases, University Childrens hospital, University medical centre, Ljubljana, Slovenia. 13. Hospital Dona Estefânia, Unit of Pediatric Endocrinology and Diabetes, Lisbon, Portugal. 14. Paediatric Endocrinology, Department of Paediatrics & Child Health, Cork University Hospital, Cork, Ireland. 15. Associação Protectora dos Diabéticos de Portugal (APDP), Lisbon, Portugal. 16. Department of Pediatrics, P & A Kyriakou Children's Hospital, Diabetes Centre, Athens, Greece. 17. Department of Paediatrics, University Hospital Motol and 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic. 18. Institute of Endocrinology, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania. 19. Children's University Hospital Children's Endocrinology Centre, Riga Stradins University, Riga, Latvia.
Abstract
BACKGROUND: Although type 1 diabetes (T1D) remains the most frequent form of diabetes in individuals aged less than 20 years at onset, other forms of diabetes are being increasingly recognized. OBJECTIVES: To describe the population of children with other forms of diabetes (non-type 1) included in the multinational SWEET (Better control in Pediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) database for children with diabetes. METHODS: Cases entered in the SWEET database are identified by their physician as T1D, type 2 diabetes (T2D) and other types of diabetes according to the ISPAD classification. Etiologic subgroups are provided for other types of diabetes. Descriptive analyses were tabulated for age at onset, gender, daily insulin doses, and hemoglobin A1c (A1C) for each type and subtype of diabetes and when possible, values were compared. RESULTS: Of the 27 104 patients included in this report, 95.5% have T1D, 1.3% T2D, and 3.2% other forms of diabetes. The two most frequent etiologies for other forms of diabetes were maturity onset diabetes of the young (MODY) (n = 351) and cystic fibrosis-related diabetes (CFRD) (n = 193). The cause was unknown or unreported in 10% of other forms of diabetes. Compared with T1D, children with T2D and CFRD were diagnosed at an older age, took less insulin and had lower A1C (all P < .0001). CONCLUSION: In centers included in SWEET, forms of diabetes other than type 1 remain rare and at times difficult to characterize. Sharing clinical information and outcome between SWEET centers on those rare forms of diabetes has the potential to improve management and outcome.
BACKGROUND: Although type 1 diabetes (T1D) remains the most frequent form of diabetes in individuals aged less than 20 years at onset, other forms of diabetes are being increasingly recognized. OBJECTIVES: To describe the population of children with other forms of diabetes (non-type 1) included in the multinational SWEET (Better control in Pediatric and Adolescent diabeteS: Working to crEate CEnTers of Reference) database for children with diabetes. METHODS: Cases entered in the SWEET database are identified by their physician as T1D, type 2 diabetes (T2D) and other types of diabetes according to the ISPAD classification. Etiologic subgroups are provided for other types of diabetes. Descriptive analyses were tabulated for age at onset, gender, daily insulin doses, and hemoglobin A1c (A1C) for each type and subtype of diabetes and when possible, values were compared. RESULTS: Of the 27 104 patients included in this report, 95.5% have T1D, 1.3% T2D, and 3.2% other forms of diabetes. The two most frequent etiologies for other forms of diabetes were maturity onset diabetes of the young (MODY) (n = 351) and cystic fibrosis-related diabetes (CFRD) (n = 193). The cause was unknown or unreported in 10% of other forms of diabetes. Compared with T1D, children with T2D and CFRD were diagnosed at an older age, took less insulin and had lower A1C (all P < .0001). CONCLUSION: In centers included in SWEET, forms of diabetes other than type 1 remain rare and at times difficult to characterize. Sharing clinical information and outcome between SWEET centers on those rare forms of diabetes has the potential to improve management and outcome.
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